HIV and Substance Use in the Pacific

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DESCRIPTION (provided by applicant): Garment and other contract workers account for more than half of the population of the Commonwealth of the Northern Marianas Islands (CNMI). The majority are immigrant laborers who are young women from Asia and other Pacific Islands, and who are exposed to harsh working and living conditions. Allegedly, some women have been forced into the sex trade, whereas others may choose to participate in the sex industry (e.g., because it is lucrative). It is hypothesized that these stressors result in substance use and risky sexual practices, which can lead to the aquisition of HIV and other sexually transmitted diseases (STDs). To date, data on substance use, STDs and HIV risk behaviors among CNMI contract workers are sparse, however, the CNMI experienced a methamphetamine epidemic in recent years and its use is believed to be prevalent. This prospective study will measure baseline substance use and sexual history via an interviewer-administered questionnaire as part of government-sponsored HIV/STD screening, which is required by the workers' employment contract upon entry into the CNMI. Prevalence and correlates of substance use, HIV and STDs will be determined. Subsequent visits at six months and one year would measure changes in substance use and sexual practices, as well as stress, depression, and suicidal behavior, in addition to HIV/STD testing. Identifying incident HIV/STD cases and the correlates of infection among the female migrant workers could aid in the design of HIV/STD education programs for contract workers, prevent spread of HIV/STDs to/from women working in the sex trade, and identifying appropriate treatment options for those infected young women.